There is a fine line between raising awareness of risk and creating fear in a community. How can you avoid creating fear when raising awareness of a disease?
November 2021: Fear or Awareness?
November 2021: Fear or Awareness?
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Raising awareness among girls, boys, women and men is one of the most key critical topics, depending on the social norms, availability of basic services in camp setting. For instance, it is essential to have basic water for drinking and other personal hygiene along with availability of hygiene supplies prior advocating IDPs on the importance of hand washing with water and soap. Showing them the correct steps of hand washing and showing them how the effect of water and soap on killing disease rather than killing germs. Using methods, like singing a song for children on hand washing, while we are showing parents the negative impact of not washing hands after using toilets through tent to tent promotional campaign and compare the cost of bringing their children to HCF and washing their hands.
In raising awareness of risks are we not linking existing illness and death to the cause of these and also its reduction or prevention. People might not know or see the linkages but do see the illness and death and that is part of raising awareness of the risk is.
It is much more difficult when people have already defined for themselves the causes and possibly attributed them to external actors such as the UN or INGOs as was the case in the DRC ebola crisis. We have to be sensitive to existing knowledge but also counter rumours in an effective way (using respected communicators, using language and channels that people trust). 'A lie travels half way around the globe while the truth is putting on its shoes' Mark Twain.
It is more difficult when our means to tackle the disease takes people away from families, isolates them and possibly only returns them when they are dead. Even then they have to be buried or cremated with extreme care, reducing the family's ability to mourn in a way that they see as appropriate.
I've worked in some places where people will always answer NO to questions such as "do you think someone in your family could get diarrhea in the next 6 months?" because they believe saying yes may cause it to happen. No matter how you re-phrase such questions, they will always say no. Has anyone else had this experience? How do go about collecting information about disease perception in a context where people never admit to illness of the potential for illness?
I see they understand the power of words ! In this context, you may ask them about their past, because most likely it DID happen to them in the past. Explaining that they cannot deny it may happen in the future but they can deny the power of this disease to knock them down by doing simple actions to avoid this or reduce the lethal impact. It requires a deeper sociological analysis as it is most likely linked to spirituality or religion, so you may use a well respected religious authority to disseminate that right message, for instance during the preaching on Sunday. Once you convince leaders/elders, it is easier to get the rest following. I would suggest to conduct such a sociological study in parallel if time allows, to identify the determinants and roots of their attitude, which is respectable and understandable, as words DO have power, bad or good so we should use them wisely !
Thanks for these insights Jainil! Indeed, we have to be thoughtful about how we ask questions.
it could happen, in such circumstance better to link the previous history with the future and make clear that as far no the situation changed no guarantee not to be catchup by diarrhea
In my opinion, when there is an outbreak, people are always confused, disgusted, or even afraid that something bad may happen to them too. Raising awareness may be appropriate mechanism to make people first understand the reasons behind the outbreak. Someone must be there to tell the history of the community before the outbreak so that they realize that something must have gone wrong either with their behaviour or something else. This might be far much better rather than displaying messages like "beware this disease might kill you" or "wash your hands or else you will die". The quality of the message must be refined.
This is such a good point, Francisco. I'm sure all of us can relate to similar feelings after having experienced COVID-19 and how people communicated about the associated risks. It is possible to raise awareness without causing a panic even though it is difficult!
I agree.personal histories can be of help here.Moving the group from where they were and where they are and the potential risk of where they are going can truly open their eyes to appreciate the impeding dangers ahead.
Fear which may take the form of threat as the undesirable consequence of not performing the behaviour is considered to sometimes immobilize the target group. The following factors are suggested while choosing fear-based messages – (i) when the fear-based appeal is strong, also provide solutions that are both effective and easy to perform, otherwise use a moderate appeal to fear; (ii) a strong fear-based appeal may be most persuasive to those who have previously been unconcerned, those who already have some concern may perceive a message of fear as going too far inhibiting their change of attitudes or behaviours; (iii) an appeal to fear may work better when it is directed toward someone who is close to a potential target adopter than it is when directed to the target adopter (such as when directed toward family members of the target group); (iv) the more credible the source, the more persuasive are the fear-based appeal.
Excellent tips, Laxman! Thank you for providing suggestions on how to make a more balanced approach.
Powerful and thank you for the insights
Raising awareness can be done through giving very clear picture of the disease explaining the disease its self , causes and effect but to avoid the fear a disease left on the population can be done through addressing simple but effective ways of prevention and telling the population that if you practice these methods of prevention a very serous disease can be highly preventable . This was what we have experienced during the Covid-19 outbreak which made people to get accustomed to handwashing and high hygiene practices.
I agree with your reflection especially when you give the right information you demystify the myths and run away from the risk of misconceptions.
Better knowing the community through the baseline and initial surveys, this would help in reducing the community fear when designing and implementing the awareness program
Good point, Ihab. Some people are not motivated by fear at all! It is important to know what is motivating for a community to make a change.
I agree.Baseline gives the comparison of behaviour change and hw things may turn to be i the near furture if prudent measures are not considered to remedy situations.
Raising awareness about a disease outbreak has that wasn’t known before can be a useful tactic when it’s part of a larger effort to drive social behavioural changes.
But to truly drive behaviour change, we have to consider that shows there is a more strategic, effective, and focused way to drive social behaviour change. In fact, most research suggests that not only do campaigns fall short and waste resources when they focus solely on raising awareness of a diseases outbreak but sometimes they can actually end up by raising fears in the audiences.
Before exploring the most effective ways to create awareness, it’s important to understand the ineffective and lead to fear that awareness of a disease can have. When done wrong, an awareness campaign might carries bellow main specific risks:
• It might lead to no action
• It might reach the wrong audience
• It might create harm and
• It could generate a backlash.
I think before planning the awareness campaigns ,it would be need to examine each of the risks in turn. Identifying the right target audience and delivering a clear call to action that people will act on isn't dark magic.
for raising the awareness and to understand what the risk form disease and how can they protect there selves and their family
In my experience raising awareness campaign's aimed at change behavior may have limited success. A impact survey I was involved in once, showed know a health center messaging had increased knowledge of a disease ( diarrhoea ) but it did not change behavior. The reasons why it did not change behavior was 1. Mother in Law said it was not true and the mother had to obey her. 2. Non local remedies were prescribed which the local community could not afford to get. 3. The person perception was that the disease would not effect her. For that reason the combination of Wash-em tools is attractive!
Thanks for sharing Cathy, it's interesting to see the barriers that mother faced - there were quite a few! Yes, hopefully tools like motives and disease perception would help get around some of these barriers and result in a campaign that resonates with people.
I agree that this is the time we need to marry Wash'em tools,Personal histories here can give the clear picture of disease prevalence and perceptions. One tool can not help in highlighting the true picture of the situation in such a situation.
Give hope through prevention measures
sure it happen, but to minimize the fear explaining the risks and the solution side by side and inspire them to exercise it that motivate them instead of creating fear.
True. Making the people understand the situation ,impeding dangers and control or preventive measures give them hope and remove fear.
There is need to look at the positive side of being healthy, look at what a family will be saving in terms of money and time if all members are in good health. thereafter, look at how does a family sustain being healthy.
Context, culture and peoples emotional wellbeing will inform as to how you talk about the disease. Fear should not be generated and this should be done by awareness raising in an understandable manor about the scale of the risk relative to other risks. Also how so deal with the should be made to sound as simple as possible. Practical demonstrations and open participation will help people to feel more comfortable with the information being communicated.
Creating fear when raising awareness is common among the field staffs who may be unaware of the consequences. You can avoid creating fear through demystification of myths and giving the true facts of the situation while sharing the statistical data or any viable evidence. Highlight the necessary information about the condition and answer any questions pertaining the subject under discussion.
When I've taught HP, I don't focus on hand washing initially. I use smoking as an example, looking at people's motives for smoking or for giving it up. Awareness of the health problems is normally high, but the motives are often not directly health related. Even when people are worried about health, often the reason is about being able to play sport. Whilst disease might be an important reason for HP, it may not be the most important driver for change. Finding out the existing level of awareness is useful - people may know the issues already but still not act. This is why assessing the situation before acting is good.
Awareness creation requires tactful choice of words depending on the context so as to prevent causing fear or a turn off from the target beneficiaries. As such, positive messaging would be the way to go. For example; wash your hands with soap and water to avoid frequent hospital visits, safe productive time and have healthy and happy babies. Here you are using motivators as focus in your message instead of negative things like sickness and death.
First it is very important to understand the facts of the risk of the disease you are passing information on. With these facts, your audience will get the right information which has not been exaggerated. This will allow them weigh the risk to themselves, families and close friends
At the same time you need to enlighten the audience on the modes of transmission. This will clearly enable them to evaluate themselves on such and look in to whether they are at a risk of conducting given their current living conditions/ knowledge information.
Explaining your audience on the prevention of the same disease will be key as this will keep their psychology at a level that they are safe if they maintain certain standards /adhere to specific measures. This gives them hope other than panicking.
If the disease is curable, enlighten the audience that the disease is curable so that the they are aware that falling sick is not a death trap.
When discussing about a particular disease, it is important to provide facts on how it is transmitted, causes, prevention. Including giving statistics on a global level. If there are ways/methods used in other locations/areas and how successful they have been,.
When we are providing hygiene promotion messages in the community we are working, we emphasis on the benefits of washing hands with soap, drinking treated and safe water, use of latrines etc. This ensures community do not feel disgusted and avoid our Hygiene Promoters.
In CLTS, the approach creates disgust and triggers community to act.
However, in disease tool, we need to empathize with community members, and through discussions see if the cause of disease, so that interventions surround how to prevent it.
It is possible to raise awareness about disease and see the positive outcomes in peoples behaviour without creating fear. There are many ways we can look over like, advertisement. Advertisement itself is a vague term as it includes strategy and power to motivates and manipulate the peoples thought process. So in the concept of disease as well it informs the target population that the disease exist and it may cause problems only if you do not follow basic health protocols like hand washing, consuming fresh food and pure drinking water and so on. But again at the same time the consequences/ risk on others health directly leads to behaviour change in rest of the population. People automatically get scared of others health issues and change over a period of time. This means they get aware by themselves after the risk arouse.
Sure. I agree with you. It would be better to explore the create ways to promote behavior change rather than just creating the fear over the diseases.
If you see in the CLTS approach, Its about creating fear among the population - Fear of eating shit (5 F diagram, Shit calculations), Fear of insults (Flagging with names), etc. SO creating fear is important. But off course, the remedies / solutions should also be provided.
Awareness is important to minimize the disease or its risk. If there are the chances of being fear with the diseases while giving awareness it should be linked with different aspect according to the audience type such as give awareness of handwashing to the mother group relating to their child health (If a mother do not wash her hands how her child could be healthy and how the child could come up with her dreams). Aware the adult person relating to the economic aspect (how they can save money if they do handwashing : if they spend money to buy soap now, then they will save the money that would be spend in healthcare).
The most important factor for awareness raising is for disease prevention and thus it is essential to share about the preventive measures among community people. If we happen to share information with more focus on disease prevention, creating fear can be avoided or reduced and raising awareness can be improved.
In humanitarian situation hunger itself could be a disease that can impede person or family to perform certain hygiene behaviours as expected by WASH programme. Disease may be perceived differently given the condition that they are in and diarrhoea may not be a priority if it is not life threatening to him or her. Therefore, i feel it will be a challenge and we need to a have better grip on interpersonal communication skills to get the closest response.
In order to create a positive change in behavior as prevention from any disease, it is important to provide true information about the cause, transmission and prevention of that particular disease. If these information and facts are provided in a way that community people can easily understand, giving example of similar cities and communities and how the disease was kept under control due to awareness and prevention methods taken by the community people, this will eliminate fear of that disease and encourage people to take measures.
Well, to me, creating positive fear is important for an effective awareness. For example, when people will gain the fear on cholera or diseases, they will maintain hygiene to keep them safe from the diseases. But yes, negative fear should not be created to follow the "Do no Harm" principle. Negative fear might demotivate them more.
Raising awareness about disease in a community can create fear specially if only demand side is being addressed. The people should not only be aware but should be able to take action to prevent the disease. The awareness raising must entail positive motivational messages and the communities should be linked with the services. The right selection of the target groups to create awareness in the community is also very helpful. For inter personal communication channels the existing community structures are more useful for dissemination of context based messages.
I think fear cannot be totally avoided, especially in introducing new diseases like COVID-19 for example when it first came out. But what can be done is to clearly explain that the community can 1) do actionable steps to prevent it and 2) provide a clear plan on how to manage in case they get the disease. This allows people to feel like they have a sense of control over disease prevention and in case they do get the disease, that it is manageable and there are several avenues they can take depending on the disease severity, to recover from it. That being said, there are other issues aside from the health risk that must also be considered. For example the fear of losing income if they get the disease, or being discriminated against by the community. These are valid concerns that would need other approaches to address. It is therefore important to understand where the fear is coming from and to address those as necessary.